Description In Birmingham, Alabama, racial segregation, income inequality, and violent crime contribute to an environment in which many adolescents are at risk for negative health and psychosocial outcomes. When young people are not resilient to adverse circumstances they may develop behaviors that contribute to a cycle of illness and an inability to thrive that can continue into adulthood. Chronic health problems not only threaten individual success but, in aggregate, may also hold back community development.

Researchers are determining what factors contribute to emerging adults' becoming resilient to health risks prevalent in Birmingham's largely African-American, disadvantaged urban neighborhoods. Resilience promotes positive outcomes despite adverse circumstances. Young people aged 15 to 24 experience a period of rapid physical, mental, and social change as well as economic challenges that can prepare them for the responsibilities of adulthood. However, negative health behaviors developed in early adulthood also affects physical and mental health later in life. The researchers are studying how some individuals and social networks resist negative influences and adopt strong, positive behaviors.

In Phase One of the project, researchers are working with a faith-based group, Congregations for Public Health (CPH), to identify social network leaders who can recruit hard-to-reach peers. The researchers will interview adolescents characterized as resilient to determine the qualities that help them resist negative influences. These qualities will serve as the basis for training high-risk peer leaders during the project's second phase. The researchers are also determining which set of modifiable risk factors for example, substance abuse, sexual activity, and violence or low physical activity, poor nutrition and obesity are most amenable to intervention.

In Phase Two, adolescents found to be resilient will serve as a control group. High-risk adolescents will be given a brief health promotion component and then randomly assigned to intervention and non-intervention groups. The intervention will be peer-led and will use participant-identified channels to deliver collaboratively generated content. The center will train CPH staff to be community health advisors who will deliver intervention material to leaders in the social networks and participate in data gathering and evaluation. Researchers will conduct 8-, 16-, and 24-month follow-up assessments of participants to gauge how well they are avoiding the selected health risk behaviors.